Hospitalizations of Spinal Cord Injury Patients in Rural Australia: A Descriptive Study over a Six-Year Period.

Abstract

To investigate: (1) the number of hospital admissions, discharges, and transfers; and (2) the principal diagnoses, length of stay (LOS), and mortality rates among patients with spinal cord injuries (SCI) in rural Australia. Descriptive Study SETTING: Forty-one hospitals in Western New South Wales Local Health District (WNSWLHD), Australia PARTICIPANTS: Patients at least 18 years of age with SCI who have at least one hospital admission documented in electronic medical records within the rural WNSWLHD between 2014 and 2019 INTERVENTIONS: N/A MAIN OUTCOME MEASURES: Number and LOS of hospital admissions, discharges and transfers, principal diagnoses, and mortality outcomes RESULTS: One hundred and five patients, with an average age of 52 ± 16, and the majority being male (83%), had 455 hospital admissions. Twenty out of forty-one (49%) hospitals had at least one admission for patients with SCI. Three hundred and forty-four (76%) admissions were discharged home, whilst 32 (7%) admissions were transferred to metropolitan tertiary hospitals. Out of the 105 patients, 49 (47%) were transferred to another NSW health facility at least once. A total of 4,727 bed days (MD=4.0, IQR=1.0-10.0) were attributed to patients with SCI. Patients spent a median of 22 bed days (IQR= 6.0-60.5) in hospital. Genitourinary conditions had the greatest number of admissions with a total of 156 admissions and 585 bed days (MD=1.0, IQR=1.0-4.0). Rehabilitation had the highest number of bed days, with 26 admissions and 901 bed days (MD=23.5, IQR=14.0-40.5). 11 (10%) patients died during their admission. Most rural SCI patients residing within WNSWLHD were able to be managed locally for a broad range of medical and surgical care needs in a bespoke, pragmatic model of care.